Barriers to adolescent chemical dependency treatment

Diane M.

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Barriers to adolescent chemical dependency treatment

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Abstract

Individuals who do not have private insurance are at a significant disadvantage when trying to access social services. It has been estimated that Washington State serves less than 30% of adolescent residents needing substance abuse services. To date no statewide surveys have been completed to help determine what prevents youth from accessing much needed services such as crisis services, detoxification, outpatient treatment, and inpatient/residential treatment. Over the last few years there has been a steady increase in the number of youth who are being referred from different systems into these services. While this state has many certified agencies that work with youth, many barriers still exist that prevent them from receiving the care they need. The data collected from this project, surveying parents seeking treatment for their adolescent and adolescents who are legal adults, begins to identify some of the most common barriers encountered along the adolescent continuum of care for substance abuse.

Abstract.
Introduction and literature review.
1. A child in need of chemical dependency services.
2. Families with private or public health insurance.
3. Identification of a chemical dependency problem.
4. Wu, P Hoven and Fuller's find on Medicaid recipients.
5. Access to substance abuse treatment.
6. The DSHS brochure 'A Guide for Parents' (2006).
Method.
1. Approval from the Eastern Washington University Institutional Review Board (IRB).
2. The study design.
3. The first question of the survey.
Analysis.
Results.
Discussion.
References.

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[...] Adolescents age 18 or 19 and parents of adolescents ages 13-17 who received referrals by calling or emailing the Teenline would have been asked if they would be interested in participating in an on-line survey inquiring about barriers to adolescent chemical dependency treatment, and their experience with referrals received from Teenline. The survey was constructed by the authors with knowledge and support of the Twenty-Four Hour Alcohol Drug Help Line/Teenline management. Those who would have been interested would have been directed to a Zoomerang® survey located at www.zoomerang.com/survey.zgi?p=WEB225HYWT4FQD. [...]

[...] Retention in Publicly Funded Methadone Maintenance Treatment in Two Western States. The Journal of Behavioral Health Services & Research 43-60. Deck, D.D., McFarland, B.H., Titus, J.M., Laws, K.E., Gabriel, R.M. (2000). Access to substance abuse treatment services under the Oregon Health Plan. JAMA: The Journal of the American Medical Association [NLM - MEDLINE] 2093-9. Libby, A.M. & Riggs, P.D. (2005). Integrated Substance Use and Mental Health Treatment for Adolescents: Aligning Organizational and Financial Incentives. Journal of Child and Adolescent Psychopharmacology [...]

[...] In addition to the “regular” medical insurance network, the family must negotiate a separate system to obtain chemical dependency treatment with different points of contact, rules, claim forms, etc. Once services are obtained, it is often up to the parents to coordinate care between chemical dependency, mental health and primary care providers; access to and quality of care in each of these areas may suffer due to lack of communication. In an analysis of access to Medicaid-funded substance abuse treatment in Oregon, Deck, McFarland, Titus, Laws and Gabriel (2000) found that after a shift to managed care the percentage of persons enrolled in substance abuse treatment increased from in 1994 to in 1997. [...]

[...] This is especially true for adolescent care as opposed to adult chemical dependency treatment services. In a 2005 study of adolescent mental health and substance abuse treatment available to rural adolescents in Iowa, Anderson and Gittler found that the capacity for specialized services for adolescents has historically been insufficient, especially in regards to child psychiatrists and certified alcohol and drug abuse counselors. Although 43% of the youth receiving mental health services were diagnosed with co-occurring substance abuse of those youth received no treatment for substance abuse during the study period. [...]

[...] Shifting funding priorities among private health insurance providers, Medicaid coverage and block grant funding for substance abuse treatment services complicate any attempt to obtain a clear view of the current situation with regard to adolescent access to chemical dependency treatment. It is also noted that none of the studies found in preparation for the literature review asked the parents of adolescents in need of chemical dependency treatment what their experience of access to treatment was. This is an important gap in the knowledge base because, although there are exceptions, parents generally arrange for and consent to their adolescent's chemical dependency treatment. [...]

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